Risk factors for corneal nerve fiber loss in Chinese patients with type 2 diabetes mellitus.

AIMS

The length of corneal nerve fibers (CNFL), a sensitive parameter for predicting early diabetic peripheral neuropathy (DPN), is influenced by abnormal glucose and lipid metabolism. We examined related glucose and lipid factors affecting CNFL in patients with type 2 diabetes mellitus (T2DM) and their diagnostic value in detecting abnormal CNFL.

METHODS

Corneal nerve fiber and branch densities were evaluated in 150 patients with T2DM using corneal confocal microscopy and 80 patients underwent continuous blood glucose monitoring for 3 days.

RESULTS

Multiple stepwise regression revealed that HbA1c, coefficient of variation (CV) of blood glucose, and low-density lipoprotein cholesterol (LDL-C) levels were independently correlated with CNFL. The area under the curve for HbA1c, CV, and LDL-C level were 0.649, 0.643, and 0.642 respectively. With corresponding sensitivities of 0.804, 0.625, and 0.857; specificities of 0.458, 0.750 and 0.417; and optimal cutoff values of 7.55, 25.06, and 1.985.

CONCLUSIONS

HbA1c, CV, and LDL-C levels are independently associated with CNFL in T2DM patients. Combining three factors showed good performance for detecting abnormal CNFL and these may accordingly serve as intervention targets for the early DPN prevention and treatment.